Early and Late-Term Follow-Up Results of Patients Diagnosed with Aortic Aneurysm or Aortic Dissection with Aortic Regurgitation Undergoing Aortic Valve Repair or Valve-Sparing Aortic Surgery

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 36; no. 2; pp. 192 - 200
• Main Authors: Yiğit, Görkem, Özen, Anıl, Çetinkaya, Ferit, Ünal, Ertekin Utku, İşcan, Hakki Zafer, Birincioğlu, Cemal Levent, Sarıtaş, Ahmet
• Format: Journal Article
• Language: English
• Published: Sao Paulo Sociedade Brasileira de Cirurgia Cardiovascular 01-01-2021
• Subjects: Aneurysm, Dissecting; Aortic Aneurysm; Aortic aneurysms; Aortic dissection; Aortic Valve; Aortic Valve Insufficiency; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiovascular disease; Chronic obstructive pulmonary disease; Ejection fraction; Heart surgery; Heart Ventricles; Marfan syndrome; Mortality; Original; Patients; Postoperative Period; Prostheses; Replantation; Social sciences; Stroke Volume; SURGERY; Surgical outcomes; Heart Ventricles; Stroke Volume; Aortic Aneurysm; Postoperative Period; Aortic Valve Insufficiency; Replantation; Aortic Valve; Aneurysm, Dissecting
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2020-0133

Introduction: Valve-reimplantation and remodelling techniques used in aortic reconstruction provide successful early, mid, and long-term results. We present our early and late-term experience with 110 patients with aortic regurgitation (AR) who underwent aortic valve repair (AVr) or valve-sparing aortic root surgeries (VSARS) due to aortic dissection or aortic aneurysm. Methods: Nine hundred eighty-two patients who underwent aneurysm or dissection surgery and aortic valve surgery between April 1997 and January 2017 were analysed using the patient database. A total of 110 patients with AR who underwent AVr or VSARS due to aortic dissection or aortic aneurysm were included in the study. Results: In the postoperative period, a decrease was observed in AR compared to the preoperative period (P<0.001); there was an increase in postoperative ejection fraction (EF) compared to the preoperative values (P<0.005) and a significant decrease in postoperative left ventricle diameters compared to the preoperative values (P<0.001). Kaplan-Meier analysis revealed one, two, four, and five-year freedom from moderate-severe AR as 95%, 91%, 87%, and 70%, respectively. Freedom from reoperation in one, two, and five years were 97.9%, 93.6%, and 81%, respectively. Eight patients (7.4%) underwent AVr during follow-up. Out of the remaining 100 patients, 13 (12%) had minimum AR, 52 (48%) had 1st-2nd degree AR, and 35 (32%) had 2nd-3rd degree AR during follow-up. Conclusion: For the purpose of maintaining the native valve tissue, preserving the EF and the left ventricular end-diastolic diameter, valve-sparing surgeries should be preferred for appropriate patients.